Left atrial flow velocity distribution and flow coherence using four‐dimensional FLOW MRI: A pilot study investigating the impact of age and Pre‐ and Postintervention atrial fibrillation on atrial hemodynamics

Fluckiger, Jacob U.; Goldberger, Jeffrey J.; Lee, Daniel; Ng, Jason; Lee, Richard; Goyal, Anil; Markl, Michael

doi:10.1002/jmri.23994

Cited by 73 publications

(78 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…93–97 4D flow MRI is uniquely suited for evaluation of LA flow velocities (an index of atrial function) as it can provide blood velocity in 3 orthogonal directions with full volumetric coverage of the LA throughout the cardiac cycle with a single, free-breathing 10–15 minute acquisition. 94, 97–99 The 3D segmentation of LA volume enables quantitative analysis of 3-directional velocities inside the entire LA over all time frames of the cardiac cycle. 99 Recent studies demonstrated low inter-observer variability and good test-retest reliability for the quantification of blood flow velocities and other hemodynamic parameters.…”

Section: Techniques For Evaluating Atrial Myopathy - Substrate For Afmentioning

confidence: 99%

“…94, 97–99 The 3D segmentation of LA volume enables quantitative analysis of 3-directional velocities inside the entire LA over all time frames of the cardiac cycle. 99 Recent studies demonstrated low inter-observer variability and good test-retest reliability for the quantification of blood flow velocities and other hemodynamic parameters. 100–102 We have demonstrated the potential for this technique to identify different flow patterns in patients with AF, even for those not in sinus rhythm during imaging.…”

Section: Techniques For Evaluating Atrial Myopathy - Substrate For Afmentioning

confidence: 99%

“…100–102 We have demonstrated the potential for this technique to identify different flow patterns in patients with AF, even for those not in sinus rhythm during imaging. 99, 103 …”

Section: Techniques For Evaluating Atrial Myopathy - Substrate For Afmentioning

confidence: 99%

See 2 more Smart Citations

Evaluating the Atrial Myopathy Underlying Atrial Fibrillation

et al. 2015

Self Cite

View full text Add to dashboard Cite

Atrial disease or myopathy forms the substrate for atrial fibrillation (AF) and underlies the potential for atrial thrombus formation and subsequent stroke. Current diagnostic approaches in patients with AF focus on identifying clinical predictors with evaluation of left atrial size by echocardiography serving as the sole measure specifically evaluating the atrium. Although the atrial substrate underlying AF is likely developing for years prior to the onset of AF, there is no current evaluation to identify the pre-clinical atrial myopathy. Atrial fibrosis is one component of the atrial substrate that has garnered recent attention based on newer MRI techniques that have been applied to visualize atrial fibrosis in humans with prognostic implications regarding success of treatment. Advanced ECG signal processing, echocardiographic techniques, and MRI imaging of fibrosis and flow provide up-to-date approaches to evaluate the atrial myopathy underlying AF. While thromboembolic risk is currently defined by clinical scores, their predictive value is mediocre. Evaluation of stasis via imaging and biomarkers associated with thrombogenesis may provide enhanced approaches to assess risk for stroke in patients with AF. Better delineation of the atrial myopathy that serves as the substrate for AF and thromboembolic complications might improve treatment outcomes. Furthermore, better delineation of the pathophysiologic mechanisms underlying the development of the atrial substrate for AF, particularly in its earlier stages, could help identify blood and imaging biomarkers that could be useful to assess risk for developing new onset AF and suggest specific pathways that could be targeted for prevention.

show abstract

Section: Techniques For Evaluating Atrial Myopathy - Substrate For Afmentioning

confidence: 99%

Section: Techniques For Evaluating Atrial Myopathy - Substrate For Afmentioning

confidence: 99%

See 1 more Smart Citation

Evaluating the Atrial Myopathy Underlying Atrial Fibrillation

et al. 2015

Self Cite

View full text Add to dashboard Cite

show abstract

“…In healthy young subjects with normal rhythm, blood pressure, and flow, the LA appears to avoid any sustained stasis of blood. 36 Atrial thrombosis was related with some factors such as stasis of blood flow and hypercoagulable status. 8 AF is closely associated with these factors and an increased risk of both LA and RA thrombosis, 5,37 but the number…”

Section: L-arginine Treatment Increased No Production and Decreased Tmentioning

confidence: 99%

Enhancement of Endothelial Function Inhibits Left Atrial Thrombi Development in an Animal Model of Spontaneous Left Atrial Thrombosis

Mawatari

Yoshioka

Toda

et al. 2014

Circ J

View full text Add to dashboard Cite

“…4D Flow CMR has previously been applied for analysis of blood flow in both healthy subjects and patients regarding the ventricles (47,60,61,63,66,67) and the atria (68,69) of the heart, heart valves and valve prostheses (70)(71)(72), aorta (73)(74)(75)(76)(77), pulmonary vessels (78), and other arteries and veins in the body (79,80). Quantification of flow can be performed from measurements of basic blood flow volumes and velocities to advanced estimations of derived hemodynamic markers such as turbulent kinetic energy (TKE) (81)(82)(83), pressure gradients (84)(85)(86), wall shear stress (87,88) and hemodynamic force (89).…”

Section: Artifactsmentioning

confidence: 99%

Assessment of Ventricular Function in Normal and Failing Hearts Using 4D Flow CMR

Zajac¹

View full text Add to dashboard Cite

Front cover: Multicolor drawing of the heart and the outflow by Dr. Staffan Wirell, handed to me the day I became a PhD student. Permission to print. ABSTRACTHeart failure is a common disorder and a major cause of illness and death in the population, creating an enormous health-care burden. It is a complex condition, representing the end-point of many cardiovascular diseases. In general heart failure progresses slowly over time and once it is diagnosed it has a poor prognosis which is comparable with that of many types of cancer.The heart has an ability to adapt in response to long lasting increases in hemodynamic demand; the heart conforms its shape and size in order to maintain adequate cardiac output. This process is called remodeling and can be triggered by pathologies such as hypertension or valvular disease. When the myocardial remodeling is maintained chronically it becomes maladaptive and is associated with an increased risk of heart failure.In many cases, heart failure is associated with left bundle branch block (LBBB). This electrical disturbance leads to dyssynchronous left ventricular (LV) contraction and relaxation which may contribute to cardiac dysfunction and ultimately heart failure. Mechanical dyssynchrony can be treated with cardiac resynchronization therapy (CRT). However, many heart failure patients do not demonstrate clinical improvement despite CRT.Blood flow plays an important role in the normal development of the fetal heart. However, flow-induced forces may also induce changes in the heart cells that could lead to pathological remodeling in the adult heart. Until recently, measurement tools have been inadequate in describing the complex three-dimensional and time-varying characteristics of blood flow within the beating heart. 4D (3D + time) flow cardiovascular magnetic resonance (CMR) enables acquisition of three-dimensional, three-directional, time-resolved velocity data from which visualization and quantification of the blood flow patterns over a complete cardiac cycle can be performed. In this thesis, novel 4D Flow CMR based methods are used to study the intraventricular blood flow in healthy subjects and heart failure patients with and without ventricular dyssynchrony in order to gain new knowledge of the ventricular function.Different flow components were assessed in normal heart ventricles. It was found that inflowing blood that passes directly to outflow during the same heartbeat (the Direct Flow component) was larger and possessed more kinetic energy (KE) than other flow components. Diastolic flow through the normal heart appears to create favorable conditions for effective systolic ejection. This organized blood flow pattern within the normal LV is altered in heart failure patients and is associated with decreased preservation of KE which might be unfavorable for efficient LV ejection. Inefficient flow of blood through the heart may influence diastolic wall stress, and thus contribute to pathological myocardial remodeling.In dyssynchronous LVs of heart failure patients with LBB...

show abstract

Left atrial flow velocity distribution and flow coherence using four‐dimensional FLOW MRI: A pilot study investigating the impact of age and Pre‐ and Postintervention atrial fibrillation on atrial hemodynamics

Cited by 73 publications

References 22 publications

Evaluating the Atrial Myopathy Underlying Atrial Fibrillation

Evaluating the Atrial Myopathy Underlying Atrial Fibrillation

Enhancement of Endothelial Function Inhibits Left Atrial Thrombi Development in an Animal Model of Spontaneous Left Atrial Thrombosis

Assessment of Ventricular Function in Normal and Failing Hearts Using 4D Flow CMR

Contact Info

Product

Resources

About